Publication bias occurs when results of published studies are systematically different from results of unpublished studies. The term "dissemination bias" has also been recommended to describe all forms of biases in the research-dissemination process, including outcome-reporting bias, time-lag bias, gray-literature bias, full-publication bias, language bias, citation bias, and media-attention bias. We can measure publication bias by comparing the results of published and unpublished studies addressing the same question. Following up cohorts of studies from inception and comparing publication levels in studies with statistically significant or "positive" results suggested greater odds of formal publication in those with such results, compared to those without. Within reviews, funnel plots and related statistical methods can be used to indicate presence or absence of publication bias, although these can be unreliable in many circumstances. Methods of avoiding publication bias, by identifying and including unpublished outcomes and unpublished studies, are discussed and evaluated. These include searching without limiting by outcome, searching prospective trials registers, searching informal sources, including meeting abstracts and PhD theses, searching regulatory body websites, contacting authors of included studies, and contacting pharmaceutical or medical device companies for further studies. Adding unpublished studies often alters effect sizes, but may not always eliminate publication bias. The compulsory registration of all clinical trials at inception is an important move forward, but it can be difficult for reviewers to access data from unpublished studies located this way. Publication bias may be reduced by journals by publishing high-quality studies regardless of novelty or unexciting results, and by publishing protocols or full-study data sets. No single step can be relied upon to fully overcome the complex actions involved in publication bias, and a multipronged approach is required by researchers, patients, journal editors, peer reviewers, research sponsors, research ethics committees, and regulatory and legislation authorities.
{"title":"Publication bias: what is it? How do we measure it? How do we avoid it?","authors":"F. Song, L. Hooper, Y. Loke","doi":"10.2147/OAJCT.S34419","DOIUrl":"https://doi.org/10.2147/OAJCT.S34419","url":null,"abstract":"Publication bias occurs when results of published studies are systematically different from results of unpublished studies. The term \"dissemination bias\" has also been recommended to describe all forms of biases in the research-dissemination process, including outcome-reporting bias, time-lag bias, gray-literature bias, full-publication bias, language bias, citation bias, and media-attention bias. We can measure publication bias by comparing the results of published and unpublished studies addressing the same question. Following up cohorts of studies from inception and comparing publication levels in studies with statistically significant or \"positive\" results suggested greater odds of formal publication in those with such results, compared to those without. Within reviews, funnel plots and related statistical methods can be used to indicate presence or absence of publication bias, although these can be unreliable in many circumstances. Methods of avoiding publication bias, by identifying and including unpublished outcomes and unpublished studies, are discussed and evaluated. These include searching without limiting by outcome, searching prospective trials registers, searching informal sources, including meeting abstracts and PhD theses, searching regulatory body websites, contacting authors of included studies, and contacting pharmaceutical or medical device companies for further studies. Adding unpublished studies often alters effect sizes, but may not always eliminate publication bias. The compulsory registration of all clinical trials at inception is an important move forward, but it can be difficult for reviewers to access data from unpublished studies located this way. Publication bias may be reduced by journals by publishing high-quality studies regardless of novelty or unexciting results, and by publishing protocols or full-study data sets. No single step can be relied upon to fully overcome the complex actions involved in publication bias, and a multipronged approach is required by researchers, patients, journal editors, peer reviewers, research sponsors, research ethics committees, and regulatory and legislation authorities.","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"5 1","pages":"71-81"},"PeriodicalIF":1.2,"publicationDate":"2013-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S34419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68413823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Correspondence: Susan Meffert Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA Tel +1 415 476 6100 Fax +1 415 476 7404 Email susan.meffert@ucsf.edu Abstract: The impact of mass trauma on mental health and the treatment of resulting disorders has been a major focus of global mental health work since the inauguration of the field. Descriptive studies in the 1990s provided convincing evidence of the importance of addressing global mental health needs in the aftermath of mass trauma. Nonetheless, despite calls to move ahead with interventional research, few studies have tested the effectiveness of the treatments for survivors of mass trauma. In this study, we use a translational science model to review the status of intervention research for adult survivors of mass trauma with the goal of identifying promising treatments, and presenting a logic model for using available data in a manner that is sensitive to community needs, and integrating with existing systems for capacity building.
通讯:Susan Meffert，加州大学旧金山分校精神病学系，401 Parnassus Avenue, San Francisco, CA 94143, USA Tel +1 415 476 6100 Fax +1 415 476 7404 Email susan.meffert@ucsf.edu摘要:大规模创伤对心理健康的影响以及由此产生的障碍的治疗，自该领域成立以来一直是全球心理卫生工作的主要焦点。20世纪90年代的描述性研究提供了令人信服的证据，证明在大规模创伤后解决全球精神卫生需求的重要性。然而，尽管有人呼吁进行介入研究，但很少有研究测试过这种治疗对大规模创伤幸存者的有效性。在这项研究中，我们使用一个转化科学模型来回顾大规模创伤成年幸存者的干预研究现状，目的是确定有希望的治疗方法，并提出一个逻辑模型，以一种对社区需求敏感的方式使用可用数据，并与现有系统集成以进行能力建设。
{"title":"Global mental health intervention research and mass trauma","authors":"S. Meffert, S. Ekblad","doi":"10.2147/OAJCT.S37037","DOIUrl":"https://doi.org/10.2147/OAJCT.S37037","url":null,"abstract":"Correspondence: Susan Meffert Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA Tel +1 415 476 6100 Fax +1 415 476 7404 Email susan.meffert@ucsf.edu Abstract: The impact of mass trauma on mental health and the treatment of resulting disorders has been a major focus of global mental health work since the inauguration of the field. Descriptive studies in the 1990s provided convincing evidence of the importance of addressing global mental health needs in the aftermath of mass trauma. Nonetheless, despite calls to move ahead with interventional research, few studies have tested the effectiveness of the treatments for survivors of mass trauma. In this study, we use a translational science model to review the status of intervention research for adult survivors of mass trauma with the goal of identifying promising treatments, and presenting a logic model for using available data in a manner that is sensitive to community needs, and integrating with existing systems for capacity building.","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"5 1","pages":"61-69"},"PeriodicalIF":1.2,"publicationDate":"2013-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S37037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68413841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Terry, Abhinav Goyal, L. Phillips, Hillary M. Superak, M. Kutner
Correspondence: Michael H Kutner Department of Biostatistics and Bioinformatics, Emory Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322-4201, USA Tel +1 404 712 9708 Fax +1 404 727 1370 Email mkutner@emory.edu Background: The metabolic syndrome is a constellation of interrelated metabolic risk factors that appear to increase the risk of atherosclerotic cardiovascular disease, type 2 diabetes mellitus, and possibly some cancers. Animal studies and observational clinical data in humans suggest that supplemental melatonin may ameliorate a number of components of the metabolic syndrome, including elevated glucose, elevated blood pressure, dyslipidemia, and obesity. The primary objective of this clinical trial was to determine the feasibility, efficacy, and safety of melatonin supplementation in men and women with the metabolic syndrome. Methods: Thirty-nine men and women of mixed race/ethnicity were enrolled into a randomized, double-blind, placebo-controlled clinical trial with two arms: placebo for 10 weeks followed by melatonin for 10 weeks, or vice versa, with an interval 6-week washout period, in a crossover trial design. Outcome measures include metabolic syndrome components (blood pressure, glucose, triglycerides, high-density lipoprotein cholesterol, waist circumference), oxidative stress, and inflammation biomarkers. These biomarkers, along with sleep duration and quality and pretreatment endogenous melatonin levels, were measured to explore possible underlying biologic mechanisms. Discussion: This trial will provide knowledge of the effects of melatonin in metabolic syndrome subjects, and lay the groundwork for future clinical trials of melatonin in metabolic syndrome subjects.
{"title":"Design and rationale of a randomized controlled trial of melatonin supplementation in men and women with the metabolic syndrome","authors":"P. Terry, Abhinav Goyal, L. Phillips, Hillary M. Superak, M. Kutner","doi":"10.2147/OAJCT.S39551","DOIUrl":"https://doi.org/10.2147/OAJCT.S39551","url":null,"abstract":"Correspondence: Michael H Kutner Department of Biostatistics and Bioinformatics, Emory Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322-4201, USA Tel +1 404 712 9708 Fax +1 404 727 1370 Email mkutner@emory.edu Background: The metabolic syndrome is a constellation of interrelated metabolic risk factors that appear to increase the risk of atherosclerotic cardiovascular disease, type 2 diabetes mellitus, and possibly some cancers. Animal studies and observational clinical data in humans suggest that supplemental melatonin may ameliorate a number of components of the metabolic syndrome, including elevated glucose, elevated blood pressure, dyslipidemia, and obesity. The primary objective of this clinical trial was to determine the feasibility, efficacy, and safety of melatonin supplementation in men and women with the metabolic syndrome. Methods: Thirty-nine men and women of mixed race/ethnicity were enrolled into a randomized, double-blind, placebo-controlled clinical trial with two arms: placebo for 10 weeks followed by melatonin for 10 weeks, or vice versa, with an interval 6-week washout period, in a crossover trial design. Outcome measures include metabolic syndrome components (blood pressure, glucose, triglycerides, high-density lipoprotein cholesterol, waist circumference), oxidative stress, and inflammation biomarkers. These biomarkers, along with sleep duration and quality and pretreatment endogenous melatonin levels, were measured to explore possible underlying biologic mechanisms. Discussion: This trial will provide knowledge of the effects of melatonin in metabolic syndrome subjects, and lay the groundwork for future clinical trials of melatonin in metabolic syndrome subjects.","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"5 1","pages":"51-59"},"PeriodicalIF":1.2,"publicationDate":"2013-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S39551","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68413868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Dunning, P. Kluding, S. Wu, J. Feld, Jivan Ginosian, K. Mcbride
1Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, 2Department of Rehabilitation Medicine, New YorkPresbyterian Hospital/Weill Cornell Medical Center, New York, NY, 3Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS, 4Department of Biostatistics, University of Florida, Gainesville, FL, 5Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, 6Bioness Inc, Valencia, CA, USA
{"title":"The Functional Ambulation: Standard Treatment versus Electrical Stimulation Therapy (FASTEST) trial for stroke: study design and protocol","authors":"K. Dunning, P. Kluding, S. Wu, J. Feld, Jivan Ginosian, K. Mcbride","doi":"10.2147/OAJCT.S40057","DOIUrl":"https://doi.org/10.2147/OAJCT.S40057","url":null,"abstract":"1Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, 2Department of Rehabilitation Medicine, New YorkPresbyterian Hospital/Weill Cornell Medical Center, New York, NY, 3Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS, 4Department of Biostatistics, University of Florida, Gainesville, FL, 5Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, 6Bioness Inc, Valencia, CA, USA","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"68 1","pages":"39-49"},"PeriodicalIF":1.2,"publicationDate":"2013-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S40057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68414093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Wai, Lisa Marie Saldanha, Elvira Zenaida Lansang, Saumya Nayak, A. Sule, Ken J Lee
Correspondence: Karen Wai Quintiles East Asia Pte Ltd, 79 Science Park Drive, 06-08, Cintech IV, Science Park One, Singapore 118264 Tel +65 6602 1561 Fax +65 6872 0430 Email karen.wai@quintiles.com Abstract: The rheumatoid arthritis (RA) clinical trial space is very competitive, and recruiting and retaining subjects is of critical importance. Feasibility studies are a central component of ensuring successful recruitment and retention. A feasibility study is an assessment of the practicality of a proposed study protocol, with the goal of understanding challenges and providing risk mitigation strategies leading to better subject enrolment and study start-up should the assessment be favorable. This paper presents findings from a retrospective case series of RA feasibilities, describing important parameters to consider in the highly competitive RA space in Asia. Key parameters identified and discussed are how decisions on clinical development strategy necessitate changes in the clinical operational delivery strategy, with focus on changes in inclusion and exclusion criteria and patient contribution load; how small the patient population becomes when the clinical trial needs to target the patient population that is refractory to standard therapy; regulatory timelines; and the competitive clinical trial landscape. Feasibility assessments are a snapshot in time exercise. Multiple parameters change over time, and, particularly in a space that has become competitive for subjects, one cannot rely on one static feasibility assessment to predict trial performance accurately. Continuous feasibility assessment will also provide insight into the resourcing needs on the part of the sponsor, contract research organization, and investigative site.
通讯:Karen Wai Quintiles East Asia Pte Ltd, 79 Science Park Drive, 06-08, Cintech IV, Science Park One, 118264 Tel +65 6602 1561 Fax +65 6872 0430 Email karen.wai@quintiles.com摘要:类风湿关节炎(RA)临床试验空间竞争非常激烈，招募和留住受试者至关重要。可行性研究是确保成功征聘和留用的核心组成部分。可行性研究是对拟议研究方案的实用性进行评估，其目标是了解挑战并提供风险缓解战略，以便在评估有利的情况下更好地招募受试者和启动研究。本文介绍了对RA可行性的回顾性案例系列的研究结果，描述了在亚洲高度竞争的RA空间中需要考虑的重要参数。确定并讨论的关键参数是临床开发策略的决策如何使临床操作交付策略发生必要的变化，重点是纳入和排除标准以及患者贡献负荷的变化;当临床试验需要针对标准治疗难治性的患者群体时，患者群体有多小;管理时间;以及竞争激烈的临床试验环境。可行性评估是一项及时的工作。多个参数随着时间的推移而变化，特别是在一个对受试者具有竞争性的空间中，人们不能依靠一个静态的可行性评估来准确预测试验的效果。持续的可行性评估还将提供对赞助商、合同研究组织和调查地点的资源需求的见解。
{"title":"Case series of feasibility considerations that impact operational delivery strategy in the highly competitive rheumatoid arthritis space in Asia","authors":"K. Wai, Lisa Marie Saldanha, Elvira Zenaida Lansang, Saumya Nayak, A. Sule, Ken J Lee","doi":"10.2147/OAJCT.S40000","DOIUrl":"https://doi.org/10.2147/OAJCT.S40000","url":null,"abstract":"Correspondence: Karen Wai Quintiles East Asia Pte Ltd, 79 Science Park Drive, 06-08, Cintech IV, Science Park One, Singapore 118264 Tel +65 6602 1561 Fax +65 6872 0430 Email karen.wai@quintiles.com Abstract: The rheumatoid arthritis (RA) clinical trial space is very competitive, and recruiting and retaining subjects is of critical importance. Feasibility studies are a central component of ensuring successful recruitment and retention. A feasibility study is an assessment of the practicality of a proposed study protocol, with the goal of understanding challenges and providing risk mitigation strategies leading to better subject enrolment and study start-up should the assessment be favorable. This paper presents findings from a retrospective case series of RA feasibilities, describing important parameters to consider in the highly competitive RA space in Asia. Key parameters identified and discussed are how decisions on clinical development strategy necessitate changes in the clinical operational delivery strategy, with focus on changes in inclusion and exclusion criteria and patient contribution load; how small the patient population becomes when the clinical trial needs to target the patient population that is refractory to standard therapy; regulatory timelines; and the competitive clinical trial landscape. Feasibility assessments are a snapshot in time exercise. Multiple parameters change over time, and, particularly in a space that has become competitive for subjects, one cannot rely on one static feasibility assessment to predict trial performance accurately. Continuous feasibility assessment will also provide insight into the resourcing needs on the part of the sponsor, contract research organization, and investigative site.","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"5 1","pages":"33-38"},"PeriodicalIF":1.2,"publicationDate":"2013-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S40000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68414473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Yawn, S. Madison, S. Bertram, W. Pace, Anne Fuhlibrigge, E. Israel, Dawn Littlefield, M. Kurland, M. Wechsler
Barbara P Yawn1 Suzanne Madison1 Susan Bertram1 Wilson D Pace2 Anne Fuhlbrigge3 Elliot Israel3 Dawn Littlefield1 Margary Kurland1 Michael E Wechsler4 1Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women’s Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USA
Barbara P Yawn1 Suzanne Madison1 Susan Bertram1 Wilson D pac2 Anne fuhlbrigg 3 Elliot Israel3 Dawn Littlefield1 Margary Kurland1 Michael E wechsler 1 1Olmsted医学中心，研究部，罗切斯特，明尼苏达州，2UCDHSC，家庭医学部，科罗拉多大学健康科学中心，奥罗拉，科罗拉多州，3Brigham和妇女医院，肺部和重症监护部，波士顿，马萨诸塞州，4国家犹太医学中心，肺科，丹佛，科罗拉多州
{"title":"Automated patient and medication payment method for clinical trials","authors":"B. Yawn, S. Madison, S. Bertram, W. Pace, Anne Fuhlibrigge, E. Israel, Dawn Littlefield, M. Kurland, M. Wechsler","doi":"10.2147/OAJCT.S38489","DOIUrl":"https://doi.org/10.2147/OAJCT.S38489","url":null,"abstract":"Barbara P Yawn1 Suzanne Madison1 Susan Bertram1 Wilson D Pace2 Anne Fuhlbrigge3 Elliot Israel3 Dawn Littlefield1 Margary Kurland1 Michael E Wechsler4 1Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women’s Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USA","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"2013 1","pages":"23-31"},"PeriodicalIF":1.2,"publicationDate":"2013-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S38489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68413619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Correspondence: Hazel Goodale Perceptive Informatics Inc, Lady Bay House, Meadow Grove, Nottingham, NG2 3HF, United Kingdom Tel +44 115 844 3962 Fax +44 115 955 7555 Email hazel.goodale@perceptive.com Abstract: There are many documented instances in which bias has had an adverse effect on the results of clinical trials. This has led to a number of design techniques being developed that can be implemented in clinical trials in order to reduce bias. Sources of bias referring to published case studies are reviewed and discussed. The potential uses of technology to alleviate bias are outlined, particularly the use of centralized interactive response systems to randomize patients and manage medication in such a way as to limit the risk of bias caused by knowledge of either a patient’s current treatment or future treatment assignments. Potential sources of bias include selection bias, accidental bias, assessment bias, observer bias, and operational bias. These can arise through inadequate randomization and concealment methods during the trial. The blind may be broken by individual code breaks or through deduction in studies with frequent dose adjustments; there is scope for deduction in adaptive trials that might also introduce bias. Technology can reduce or eliminate the potential for bias in a variety of manners including central randomization and secure methods to protect the blinding and trial integrity. However, if the separation of randomization and dispensing, made possible by the use of technology, is not applied correctly then new unblinding scenarios can be introduced.
通讯:Hazel Goodale Perceptive Informatics Inc, Lady Bay House, Meadow Grove, Nottingham, NG2 3HF, uk Tel +44 115 844 3962 Fax +44 115 955 7555 Email hazel.goodale@perceptive.com摘要:有许多文献记载的偏倚对临床试验结果产生不利影响的例子。这导致了一些设计技术的发展，可以在临床试验中实施，以减少偏倚。对已发表的案例研究的偏倚来源进行审查和讨论。概述了技术在减轻偏倚方面的潜在用途，特别是使用集中的互动反应系统对患者进行随机分组，并以这样一种方式管理药物，以限制因了解患者当前治疗或未来治疗任务而导致的偏倚风险。潜在的偏倚来源包括选择偏倚、偶然偏倚、评估偏倚、观察者偏倚和操作偏倚。这些可能是由于试验过程中不充分的随机化和隐瞒方法造成的。在频繁调整剂量的研究中，可以通过个别代码的中断或通过推导来打破盲法;在适应性试验中有推演的余地，这也可能引入偏见。技术可以通过多种方式减少或消除潜在的偏倚，包括中心随机化和安全方法，以保护盲法和试验的完整性。然而，如果由于技术的使用而使随机化和配药分离成为可能，则不能正确应用，那么可以引入新的解盲方案。
{"title":"The role of technology in avoiding bias in the design and execution of clinical trials","authors":"H. Goodale, D. Mcentegart","doi":"10.2147/OAJCT.S40760","DOIUrl":"https://doi.org/10.2147/OAJCT.S40760","url":null,"abstract":"Correspondence: Hazel Goodale Perceptive Informatics Inc, Lady Bay House, Meadow Grove, Nottingham, NG2 3HF, United Kingdom Tel +44 115 844 3962 Fax +44 115 955 7555 Email hazel.goodale@perceptive.com Abstract: There are many documented instances in which bias has had an adverse effect on the results of clinical trials. This has led to a number of design techniques being developed that can be implemented in clinical trials in order to reduce bias. Sources of bias referring to published case studies are reviewed and discussed. The potential uses of technology to alleviate bias are outlined, particularly the use of centralized interactive response systems to randomize patients and manage medication in such a way as to limit the risk of bias caused by knowledge of either a patient’s current treatment or future treatment assignments. Potential sources of bias include selection bias, accidental bias, assessment bias, observer bias, and operational bias. These can arise through inadequate randomization and concealment methods during the trial. The blind may be broken by individual code breaks or through deduction in studies with frequent dose adjustments; there is scope for deduction in adaptive trials that might also introduce bias. Technology can reduce or eliminate the potential for bias in a variety of manners including central randomization and secure methods to protect the blinding and trial integrity. However, if the separation of randomization and dispensing, made possible by the use of technology, is not applied correctly then new unblinding scenarios can be introduced.","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"5 1","pages":"13-21"},"PeriodicalIF":1.2,"publicationDate":"2013-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S40760","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68414181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human papillomavirus (HPV) is one of the most common causes of sexually trans- mitted diseases worldwide. It has been proposed that the great majority of women and men have been infected with HPV at least once during their lifetime. HPV infection is associated with a variety of clinical conditions, ranging from benign lesions to cervical cancer. In most cases, the infection is transient, where most of the individuals are healing, eliminating the virus without the presence of any clinical manifestation. Actually, more than 120 HPV types have been cataloged, of which approximately 40 can infect the mucosa of the anogenital tract and are collectively known as mucosal HPV, which are classified based on their oncogenic potential as either low- or high-risk HPV types. The low-risk HPV type causes benign hyperproliferative lesions or genital warts, with a very limited tendency for malignant progression, while the high-risk HPV type is strongly associated with premalignant and malignant cervical lesions. The HPV cycle initiates when the virus gains access to undifferentiated cells of the basement membrane of the squamous columnar junction epithelium of the ectocervix, after these regions are exposed to mechanical or chemical trauma. The basal cells in the transformation zone retain the ability to differentiate, a property required for virion production. Cervical infection with high-risk HPV typically lasts from 12 to 18 months and in most cases is cleared spontaneously. However, in some women the immune response is insufficient to eliminate the virus, resulting in a persistent, long-term infection that may progress to a malignant lesion. In this review, we discuss the biology and natural history of HPV infection and its association with cervical cancer.
{"title":"Biology and natural history of human papillomavirus infection","authors":"J. V. Fernandes, J. Araújo, T. A. A. Fernandes","doi":"10.2147/OAJCT.S37741","DOIUrl":"https://doi.org/10.2147/OAJCT.S37741","url":null,"abstract":"Human papillomavirus (HPV) is one of the most common causes of sexually trans- mitted diseases worldwide. It has been proposed that the great majority of women and men have been infected with HPV at least once during their lifetime. HPV infection is associated with a variety of clinical conditions, ranging from benign lesions to cervical cancer. In most cases, the infection is transient, where most of the individuals are healing, eliminating the virus without the presence of any clinical manifestation. Actually, more than 120 HPV types have been cataloged, of which approximately 40 can infect the mucosa of the anogenital tract and are collectively known as mucosal HPV, which are classified based on their oncogenic potential as either low- or high-risk HPV types. The low-risk HPV type causes benign hyperproliferative lesions or genital warts, with a very limited tendency for malignant progression, while the high-risk HPV type is strongly associated with premalignant and malignant cervical lesions. The HPV cycle initiates when the virus gains access to undifferentiated cells of the basement membrane of the squamous columnar junction epithelium of the ectocervix, after these regions are exposed to mechanical or chemical trauma. The basal cells in the transformation zone retain the ability to differentiate, a property required for virion production. Cervical infection with high-risk HPV typically lasts from 12 to 18 months and in most cases is cleared spontaneously. However, in some women the immune response is insufficient to eliminate the virus, resulting in a persistent, long-term infection that may progress to a malignant lesion. In this review, we discuss the biology and natural history of HPV infection and its association with cervical cancer.","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"5 1","pages":"1-12"},"PeriodicalIF":1.2,"publicationDate":"2013-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S37741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68414039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neurobiological and clinical studies have shown that learning mechanisms and expectations of benefits powerfully affect the brain, mind, and body, with the potential of reliev - ing many symptoms during the course of daily clinical practice. Playing the role of antagonist is the "nocebo effect," which results from negative expectations derived from one's beliefs, previous experiences, and his or her clinical encounters that produce negative effects. Research on the nocebo effect indicates that information disclosure and the manner in which information is delivered can contribute to these adverse effects. In this article, we review neurobiological and medical studies relating to the nocebo effect, as these findings are important for the meth -
{"title":"The influence of the nocebo effect in clinical trials","authors":"L. Colloca","doi":"10.2147/OAJCT.S33730","DOIUrl":"https://doi.org/10.2147/OAJCT.S33730","url":null,"abstract":"Neurobiological and clinical studies have shown that learning mechanisms and expectations of benefits powerfully affect the brain, mind, and body, with the potential of reliev - ing many symptoms during the course of daily clinical practice. Playing the role of antagonist is the \"nocebo effect,\" which results from negative expectations derived from one's beliefs, previous experiences, and his or her clinical encounters that produce negative effects. Research on the nocebo effect indicates that information disclosure and the manner in which information is delivered can contribute to these adverse effects. In this article, we review neurobiological and medical studies relating to the nocebo effect, as these findings are important for the meth -","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"7 1","pages":"61-68"},"PeriodicalIF":1.2,"publicationDate":"2012-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S33730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68413778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. L. Goaster, Gonzalo, Bourée, Frderic Tangy, Haenni
Jacqueline Le Goaster1 Sylvie Gonzalo2 Patrice Bouree1 Frederic Tangy3 Anne-Lise Haenni4 1Department of Tropical Diseases, Centre Hospitalo-Universitaire (CHU), University of Paris XI, Le Kremlin Bicetre, 2Biomnis Laboratory, Ivry-sur-Seine, 3Retro-Virology, Centre National de Recherche Scientifique (CNRS), Pasteur Institute, Paris; 4Jacques Monod Institute, Centre National de Recherche Scientifique (CNRS), University of Paris VII, Paris, France
{"title":"Efficacy of the anti-VZV (anti-HSV3) vaccine in HSV1 and HSV2 recurrent herpes simplex disease: a prospective study","authors":"J. L. Goaster, Gonzalo, Bourée, Frderic Tangy, Haenni","doi":"10.2147/OAJCT.S33292","DOIUrl":"https://doi.org/10.2147/OAJCT.S33292","url":null,"abstract":"Jacqueline Le Goaster1 Sylvie Gonzalo2 Patrice Bouree1 Frederic Tangy3 Anne-Lise Haenni4 1Department of Tropical Diseases, Centre Hospitalo-Universitaire (CHU), University of Paris XI, Le Kremlin Bicetre, 2Biomnis Laboratory, Ivry-sur-Seine, 3Retro-Virology, Centre National de Recherche Scientifique (CNRS), Pasteur Institute, Paris; 4Jacques Monod Institute, Centre National de Recherche Scientifique (CNRS), University of Paris VII, Paris, France","PeriodicalId":19500,"journal":{"name":"Open Access Journal of Clinical Trials","volume":"4 1","pages":"51-58"},"PeriodicalIF":1.2,"publicationDate":"2012-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJCT.S33292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68413768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：